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October 3rd Tweet-a-Thon: A Day in the Life of a Pharmacist

Please join pharmacists around the world for a day of celebrating their contributions to health care and our communities.  Every day, pharmacists quietly and efficiently help patients in many ways and in many diverse practice settings.  For one day, the world will hear about it on Twitter.

On Thursday, October 3, pharmacists will tweet about the real things they are doing or did that day to help patients, other health professionals, and their communities.  While every pharmacist faces challenges in the course of his or her practice, this is a day to highlight through social media the positive impact that pharmacists have on their patients and bring attention to the good work they do to help patients live healthier lives.

Did you help a patient save money on their expensive prescription medication? 
Did you catch a wrong dosage on a doctor’s prescription, avoiding a potentially dangerous drug interaction or reaction? 
Did you resolve an insurance issue for a patient? 

Share your experiences with others around the world by tweeting them on Thursday, October 3.

WHAT IS A TWEET-A-THON?

A Tweet-a-Thon is an online event on Twitter where participants focus their tweet content for a specific time period on a particular issue. 

On Thursday, October 3, 2013, join thousands of pharmacists across the country and around the world in tweeting about the real things you are doing or have done that day to help patients, other health care professionals, and your community. 

HOW TO PARTICIPATE:

On Thursday, October 3, send one or more tweets from your Twitter account describing an action you took that day to help a patient, a health care professional, your industry, or your community.

Be sure to include in your tweet the hashtag used specifically for this event: #Pharmacist.

Tweet Examples (remember to keep your tweets under 140 characters):

  • I just saved a patient $78 by switching to a generic version #Pharmacist
  • I taught a mother an easy way to give liquid antibiotics to her daughter. #Pharmacist
  • I delivered an emergency medication to my patient in the nursing home at 10 pm last night. #Pharmacist
  • I answered a dr’s question about the best treatment option for allergies. #Pharmacist
  • I spent 20 min. on the phone w/an insurance company to help my patient save money on his prescription. #Pharmacist

 Not on Twitter?  Signing up is free and easy.  Click here for a brief how-to manual to get started.

We hope you will join us in telling the world your pharmacy success stories on October 3rd.

For more information, please contact PSSNY at 800.632.8822 or staff@pssny.org.

 

 

 

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This is an important notice about a change in state law governing the pharmacy benefit in Medicaid managed care, especially pertaining to the
so-called "specialty drugs”
 
 
The final state budget includes provisions designed to improve Medicaid Managed Care consumers’ access to all drugs at community pharmacies. As a result of these changes, every covered drug will be available at the consumer’s request from a local pharmacy that is in the network, as long as the local pharmacy is willing to accept the same price as the "mail order” pharmacy. For the sake of clarity, NYS law will now define "mail order” to mean any pharmacy whose primary business is to receive prescriptions electronically and to deliver them by mail or common carriers, such as UPS or FedEx.
 
We asked our friends in the legislature, the state senators and assembly members, to strengthen our position in Medicaid managed care and they showed very strong support for our cause. We acknowledge our gratitude for their help and for the efforts of so many pharmacy owners and pharmacists who traveled to Albany to make the case in person on March 5th at our Independent Pharmacists’ Lobby Day.
 
We must now closely monitor how this new and improved law will be implemented by the NYS Department of Health. Technically, this new law goes into effect immediately, and we would obviously like to see immediate results. However, we understand the market forces {our adversaries, the PBMs} are at work, and we must keep our eyes open to their tactics. You can help us by documenting the exact details whenever a claim for any covered drug is denied at your pharmacy for a Medicaid Managed Care patient. Please email any reports to staff@pssny.org, indicating in the subject line "Medicaid Managed Care Rejection”. Please do not include any patient-specific (privacy protected) information; include only the drug name, Managed Care Plan name, PBM name, and reason(s) for rejection. Reports from the field are very valuable in our ongoing effort to represent your interests.
 
We will keep you informed as this quickly changing situation develops.

 

 

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Click here for an Update on Owners Lobby Day 2013

 

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 2/15/2013- NEWS UPDATE - FLU UPDATE - CLICK HERE!!!!

 

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 FLU UPDATE

 

Click here for the Governor's Emergency Order - As of 2/15/20163

Click here for the Governor's Emergency Order - As of 1/24/2013

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If there is difficulty locating commercial Tamiflu for Oral Suspension, the FDA is reminding health care professionals of the FDA-approve instructions for the emergency compounding of an oral suspension from Tamiflu 75 mg capsules. These instructions provide for an alternative oral suspension when the commercially manufactured formulation is not readily available.
 
 The link below for all national distributors of flu vaccines:

 

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2012-2013 Influenza Season:
Information for Pharmacists
Source:  CDC, January 15, 2013
Background
The 2012-2013 flu season in the United States has been characterized by early and intense flu activity throughout much of the country. For the latest influenza surveillance information in the United States, see the FluView weekly report.
CDC recommends a three-step approach to fighting the flu: vaccination, everyday preventive actions (such as avoiding close contact with sick people, covering your nose and mouth with a tissue when you cough or sneeze, frequent hand washing, and staying home when sick), and the correct use of antiviral drugs, if prescribed by a doctor.
Update on Influenza Vaccine Supply
For the 2012-2013 season, 145 million doses of influenza vaccine have been produced for the U.S. market.  And, as of January 4, 2013, 128 million doses have been distributed.  At this time, while some vaccine providers may have exhausted their vaccine supplies, most providers still have available doses for administration based on a January 10-14, 2013, survey from the National Influenza Vaccine Summit.   CDC does not have a recommendation to prioritize remaining supplies of vaccine.
CDC continues to recommend influenza vaccination for all people 6 months and older. It remains especially important that people at high risk of influenza complications get vaccinated, including pregnant women, children under 5 years but especially younger than 2 years, older adults 65 years and older, and people with chronic conditions like asthma, diabetes, and heart disease.
Providers interested in ordering additional influenza vaccine can visit the Influenza Vaccine Availability Tracking System IVATS at http://www.preventinfluenza.org/ivats/ to find information regarding distributors and vaccine manufacturers that have vaccine for sale
Providers who have exhausted their influenza vaccine supply should refer patients to the flu vaccine locator tool athttp://flushot.healthmap.org/ and should work with other providers in their area, including public health, to identify supplies of vaccines and where patients can be referred.
Influenza Antiviral Medications
CDC has issued recommendations for clinicians on the use of antiviral medications for treatment and prevention of influenza. A summary is available here.
 
Update on Antiviral Availability
On January 10, 2013, the U.S. Food and Drug Administration (FDA) released information indicating there may currently be intermittent shortages of Oseltamivir Phosphate (Tamiflu) for Oral Suspension (6mg/mL 60 mL), due to increased demand for the drug. This is the pediatric suspension (liquid). Note: Influenza antiviral drugs are commercially manufactured, and supplies of these drugs are dependent upon commercial manufacturers.
Compounding of Tamiflu 75 mg Adult Capsules to make an Oral Suspension
FDA has instructions for pharmacists available online on how to compound an oral suspension from Tamiflu 75 mg (adult) capsules. These instructions provide for an alternative oral suspension when commercially manufactured oral suspension formulation is not readily available.
In some cases, clinicians can consider substituting a 30 or 45 mg capsule for children (if dose is appropriate) rather than suspension, particularly if there are spot shortages of suspension. These capsules may be opened and mixed with sweetened liquids, such as regular or sugar-free chocolate syrup, if oral suspension is not available.
CDC will provide additional information and updates as needed.
 

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Click here to View the Emergency Order change in Medicaid billing for vaccines!!!

 

NEWS UPDATES:

News Updates -  "Governor Cuomo Declares a State of Emergency for Flu Epidemic"

Please click on the above link for updates on the State of Emergenct for Flu Epidemic and other news updates!

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PSSNY Annual MidWinter Meeting Continuing Education Schedule

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Patient Complaints on Mandatory Mail Order web site URL below

www.patientmedschoice.org

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Critical Background Information on AMMO for ALL Pharmacies:

Click here for the full News Update

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1. GOVERNOR CUOMO ANNOUNCES SMALL BUSINESS EMERGENCY LOAN FUND TO PROVIDE ASSISTANCE FOR BUSINESSES AFFECTED BY SANDY
2. NCPA Disaster Relief Fund
3. OMIG New Compliance Program Webinar

1. GOVERNOR CUOMO ANNOUNCES SMALL BUSINESS EMERGENCY LOAN FUND TO PROVIDE ASSISTANCE FOR BUSINESSES AFFECTED BY SANDY

Governor Andrew M. Cuomo today announced that the New York Bankers Association (NYBA) and the New York Business Development Corporation (NYBDC) have agreed to establish a $10 million small business emergency loan fund to provide immediate financial assistance for businesses impacted by Storm Sandy. Under the fund, businesses will be able to apply for loans of up to $25,000 immediately by going to www.esd.ny.gov or calling 1-855-NYS-SANDY.

"New York’s banks are stepping up to help our state’s small businesses rebuild and restart in the aftermath of Hurricane Sandy,” Governor Cuomo said. "This loan program will help those businesses who were hit hardest by the storm get the resources they need to repair immediately, allowing them to continue to provide jobs to our communities and strength to our economy. I applaud the New York Bankers Association for providing relief to these businesses and joining the growing efforts by the private sector to help all New Yorkers recover.”

Michael P. Smith, President & CEO, New York Bankers Association said, "The banking industry understands that the quick recovery of small businesses will be key to the rebuilding of our neighborhoods. We are eager to help in this critical effort so that New York’s small business owners can get back to work, and back to providing goods and services to their communities.”

The emergency loan program will provide low-interest loans of up to $25,000 to small businesses in an expedited manner to help in the recovery efforts. The New York Business Development Corporation will manage and operate the loan program in coordination with Empire State Development (ESD).

Through the program, small businesses in affected communities will be eligible to receive loans of up to $25,000 that will be interest and payment-free for the first six months and then at one percent interest for the following two years. Eligible businesses can use the funding to cover the costs of replacement and repairs to facilities or equipment or as working capital needed to restart or continue business operations.

The emergency loan program is for independently owned and operated businesses that have fewer than 100 employees and are located in the counties designated as disaster areas: Orange, Putnam, Rockland, Sullivan, Ulster, Westchester, Nassau, Suffolk, and the five boroughs of New York City.

To be eligible to receive funding through the program, companies must have filed 2011 business tax returns and have experienced direct damage or economic hardship as a result of Sandy. Applications will be available within the week and businesses are expected to begin to receive funding five to seven days after submitting a complete application and the required documentation.

2. NCPA Disaster Relief Fund

NCPA, APhA, NJPhA and PSSNY have formed an alliance to assist those independent pharmacies damaged or destroyed during Sandy in New York and New Jersey. We are putting out a nationwide request to ask pharmacists and pharmacy owners to contribute to the NCPA Disaster Fund to help them get back on their feet and once again care foe their patients.

The NCPA Foundation's Relief Disaster Fund helps independent pharmacy owners restore their businesses in the event of a natural disaster or other adverse circumstances. A Disaster Preparedness Checklist can be downloaded from the Disaster Relief page of www.ncpafoundation.org  How can you help?

First contact your neighboring pharmacies in areas hit by storms or other natural disasters to find out how they are doing. Tell owners experiencing hardship to contact the NCPA Foundation at 703-838-2653 or ncpaF@ncpanet.org  to get information about the Disaster Relief Fund.

Then please consider making a donation. Visit the donation page of www.ncpafoundation.org  to make a tax-deductible contribution.

3. OMIG NEW COMPLIANCE PROGRAM WEBINAR

The recording for the Webinar presented by the New York State Office of the Medicaid Inspector General on November 7, "OMIG's New Compliance Program Review Assessment Form and Compliance Program Review Process," is now available on the OMIG Web site. Here is the link:

https://omig.webex.com/ec0606l/eventcenter/recording/recordAction.do?theAction=poprecord&AT=pb&renewticket=0&isurlact=true&recordID=6039007&apiname=lsr.php&rKey=572feb2251fee920&format=short&needFilter=false&&SP=EC&rID=6039007&siteurl=omig&actappname=ec0606l&actname=%2Feventcenter%2Fframe%2Fg.do&rnd=5080113763&entappname=url0108l&entactname=%2FnbrRecordingURL.do

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FOR IMMEDIATE RELEASE:

Court Orders Stay on Medicaid Excluded Drug List
"Patients Retain Right to Choose Their Local Pharmacy for Drug Therapy”
 

Read HERE

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For disaster resources from HHS, please see the following message:

Dear Region II Partners:

We hope that this message finds you well and safe. As you all are aware, Hurricane Sandy has brought devastation and challenges to many people not only in New York and New Jersey, but also to many communities along the east coast. Some of our colleagues and partners are still without power in their homes and are trying to rebuild from this natural disaster. We are sending this note to let you know that we are here for you. Although we may not be able to respond as quickly as we would like to every request or question that you may have, we will do our best to stay in touch with you and to assist as much as possible.

After being closed for a week and a half, 26 Federal Plaza is now open. Due to the effects of this storm and the unprecedented closure of the building, all Region II Staff have had to perform their duties at alternate work stations throughout the area.

Despite the challenges we have faced and will continue to confront, please be reassured that we are accessible and willing to assist in any way possible.

We are attaching in this email resources for people affected in New York and New Jersey. Feel free to consult the information listed below as well as some links that you and your constituents may find helpful.

For information on applying for disaster relief, please visit:
http://www.disasterassistance.gov/ and
http://www.fema.gov/what-information-do-i-need-applyIndividuals can call 1-800-621-FEMA (3362) or TTY 1-800-462-7585 for
the speech- and hearing-impaired.

Helpful links and email addresses:

New York State Office of Emergency Management:   http://www.dhses.ny.gov/oem/

New Jersey Office of Emergency Managementhttp://www.state.nj.us/njoem/

New Jersey assistance:  www.nj211.org

New York assistance:  www.nyc.gov

Department of Health and Human Services, Region II Staff:

Jaime Torres, Regional Director : jaime.torres@hhs.gov

Dennis Gonzalez, Executive Officer: dennis.gonzalez@hhs.gov

Joynetta Bell, Regional Outreach Specialist: Joynetta.bell@hhs.gov

Karina Aguilar, Regional Outreach Specialist: karina.aguilar@hhs.gov

Phone: 212-264-4600 / Fax: 212-264-3620

As we all patiently work and rebuild through the aftermath of this disaster, we encourage everyone to assist in their communities by offering a helping hand to a neighbor. We are confident that the resiliency of the communities of New York and New Jersey will continue to rebuild not only structures, but will develop and solidify relationships that will last long after our region is able to overcome this disaster.

Jaime R. Torres, DPM, MS
Regional Director, Region II (NY, NJ, PR,VI)
U.S. Department of Health and Human Services
26 Federal Plaza, Suite 3835
New York, New York 10278        Jaime.Torres@hhs.gov

More Helpful Links:

 Click here for a list of NJ ARC Shelters

Click here for NJ public handout

NJ mini-resource guide 2012

Click here for SAMHSA Resources for Children andYouth

Click here for NY Citizen Corps Update

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Medicaid Updates:

HCS Account Information:

Pharmacies who do not yet have a HCS account with the Department of Health need to establish one right away. It can take up to three weeks to get an account. If you have any questions concerning uploading your AAC/COD survey information through your HCS account please call: 1 (866) 529-1890 – OPT #1. Please DO NOT call BNE they cannot help you with the survey questions.

Billing for Herpes Zoster Vaccine:

You can start billing Medicaid for the Herpes Zoster vaccine for those 50 and older starting October 16th. The billing codes are: 90736 (vaccine code) and 90471 (administration code). Reimbursement is: Cost of the Vaccine + $13.23 Administration fee.

Billing for Incontinence Supplies:

Pharmacies who are currently billing for incontinent supplies under 0441 will no longer be able to do so (in the next month or two). You will need to bill under the 837P (DME Format) as a 0442. For those pharmacies already billing under a 0442, you should be OK (if using the DME 837P format). Please check with your DME billing administrator. 
 

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Temporary Suspension and Modification of Statutes and Regulations to Expand Access to Tetanus Immunizations During the State Disaster Emergency

WHEREAS, on October 26, 2012, I issued Executive Order Number 47, declaring a disaster emergency in all 62 counties in the State of New York; and

WHEREAS, on October 30, 2012, the President issued a major disaster declaration for the counties of Bronx, Kings, Nassau, New York, Queens, Richmond and Suffolk, and on November 2, 2012, extended such declaration to include Rockland and Westchester Counties;

NOW, THEREFORE, I, ANDREW M. CUOMO, Governor of the State of New York, by virtue of the authority vested in me by Section 29-a of Article 2-B of the Executive Law to temporarily suspend or modify specific provisions of any statute, local law, ordinance, orders, rules or regulations, or parts thereof, of any agency during a State disaster emergency, if compliance with such provisions would prevent, hinder or delay action necessary to cope with the disaster, hereby temporarily suspend or modify, as the case may be, during the period from the date that the disaster emergency was declared pursuant to Executive Order Number 47, issued on October 26, 2012, until further notice, the following:

Article 68 of the Education Law, and any associated regulations, to the extent that such provisions limit the ability of pharmacists already authorized to administer certain immunizations pursuant to Section 6801 and subdivision (22) of Section 6802 of the Education Law to administer tetanus toxoid containing vaccines, including those also containing diphtheria and pertussis vaccine, to persons 18 years of age or older within the federally declared counties, pursuant to a patient specific or non-patient specific regimen from a physician or certified nurse practitioner;

Article 133 of the Education Law, and any associated regulations, to the extent that such provisions limit the ability of dentists to administer tetanus toxoid containing vaccines, including those also containing diphtheria and pertussis vaccine, to persons 18 years of age or older within the federally declared counties, pursuant to a patient specific or non-patient specific regimen from a physician or certified nurse practitioner;

Article 30 of the Public Health Law and Articles 131 and 139 of the Education Law, and any associated regulations, to the extent that such provisions limit the ability of emergency medical technicians to administer tetanus toxoid containing vaccines, including those also containing diphtheria and pertussis vaccine, to persons 18 years of age or older within the federally declared counties, pursuant to a patient specific or non-patient specific regimen from a physician or certified nurse practitioner, so that such emergency medical technicians can administer vaccines under the jurisdiction of a county or city health department within the federally declared counties, provided that such county or city health department shall be responsible for supervision of the emergency medical technicians and maintaining patient records of such administration; and

Subdivision (7) of Section 6527 and subdivision (7) of Section 6909 of the Education Law, and any associated regulations, to the extent that such provisions do not permit physicians and certified nurse practitioners to prescribe and order a patient specific or non-patient specific regimen for tetanus toxoid containing vaccines, including those also containing diphtheria and pertussis vaccine, to pharmacists certified to administer vaccines pursuant to Article 68 of the Education Law, dentists licensed under Article 133 of the Education Law, or emergency medical technicians certified pursuant to Article 30 of the Public Health Law, so that such individuals can administer vaccines as set forth in this Executive Order.

G I V E N under my hand and the Privy Seal of the State in the City of Albany this ninth day of November in the year two thousand twelve.

BY THE GOVERNOR

Secretary to the Governor

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In this E-Alert: 

1. "Governor Cuomo Declares a State of Emergency for Flu Epidemic"

2.  SPECIAL ANNOUNCEMENT: U.S. Food & Drug Administration (FDA) - HIV/AIDS Update. Prezista® (darunavir) 800 mg tablet strength approved

 

1. "Governor Cuomo Declares a State of Emergency for Flu Epidemic"  - Calls on Pharmacists to Assist via Emergency Order -

On January 12, Governor Cuomo issued an Emergency Order to address the epidemic Flu outbreak that has struck New York State so hard. The Flu season came early and hard. With over 19,000 cases reported so far, an increase of over 400% over the number of cases reported during the entire 2011-12 flu season, the Governor has called on immunizing pharmacists to step up vaccinations.

In the Governor's Emergency Order, the Governor has authorized certified Pharmacists to immunize children as young as 6 months old for the influenza vaccine. This emergency order is in effect during January 12th- February 11th, 2013.   To See the Governors Emergency Order, Click here

To see the Pediatric Vaccination Guidance (Refresher) and reporting requirements please click here

To view the Waiver for use of the Thimersal in influenza vaccine please click here

To see the Governors Emergency Order Click here: http://www.governor.ny.gov/press/01122013Severe-Flu-Season

  *For more information and all downloads/Forms, please visit: www.pssny.org

Your Standing Orders:

Do you need to get your standing order modified to cover those under 18?

Visit www.PSSNY.org for updates and a model standing order for vaccinating children.

 

Vaccine Stock on Hand:

Please contact craigb@pssny.org to report your flu vaccine stock on hand. We need to find shortage areas so that the state can get vaccine to those areas. 

If your Pharmacy is not registered for the States VFC (children’s vaccine program), you can call (800) 543-7468 (outside of NYC) or (347) 396-2400 (NYC) to register your pharmacy, get your PIN # if you registered before (H1N1) and forgot it or, order children’s vaccines.

List of Vaccines:

Fluvirin 5mL MDV – 4 years of age and older

Fluvirin 0.5 mL PFS – 4 years of age and older

Fluzone 5 mL MDV – 6 months of age or older

Fluzone 0.5 mL PFS – 36 months of age and older

Fluzone 0.25 mL PediatricDose PS – 6-35 months of age

Fluzone 0.5 mL SDV – 36 months of age and older

Fluzone High-Dose 0.5 mL PFS – 65 years of age and older

Fluzone Intradermal 0.1 mL PFS – 18-64 years of age

Afluria 5 mL MDV – 5 years of age and older. ACIP recommends 9 years or older

Afluria 0.5 mL PFS - 5 years of age and older. ACIP recommends 9 years or older

FluLaval 5 mL MDV – 18 years of age and older

Fluarix 0.5 mL PFS – 3 years of age and older

FluMist 0.2 mL Live Nasal Spray – 2 years to 49 years of age

 

To see the Thimerosal Waiver for pregnant woman only letter please click here: http://www.health.ny.gov/diseases/communicable/influenza/seasonal/providers/2013-01-12_thimerosal_waiver_letter.htm

 

2.  SPECIAL ANNOUNCEMENT

 U.S. Food & Drug Administration (FDA) - HIV/AIDS Update Prezista® (darunavir) 800 mg tablet strength approved

Recently the FDA approved an 800 mg tablet strength for darunavir, an HIV-1 protease inhibitor (PI) indicated for the treatment of HIV-1 infection. The Dosage and Administration section is updated, to read: Treatment-naïve adult patients and treatment-experienced adult patients with no darunavir resistance substitutions: 800 mg (one 800 mg tablet or two 400 mg tablets) taken with ritonavir 100 mg once daily and with food.  

As a result of this approval patients will now be able to decrease the number of Prezista® tablets by half, as two 400 mg tablets will no longer be needed. Current pricing terms for PREZISTA 400mg tablets bottle of 60 tabs will be equivalent to the new PREZISTA 800mg (NDC 59676-566-30) tab bottle of 30 tabs.  It is the intention of Janssen Therapeutics to remove PREZISTA 400mg tablets bottles of 60 tabs from the market no later than May 31, 2013 as supply is depleted. Shipments to wholesalers of Prezista 400mg will cease on March 31, 2013.   More information can be found by going to http://prezista.com/sites/default/files/pdf/us_package_insert.pdf.

***UPCOMING EVENTS***

Owners Lobby Day 2013 will be Tuesday, March 5th, 2013 at The Egg - Swyer Theater.

Pharmacy Day 2013 will be Tuesday, April 16, 2013 at The Egg - Swyer Theater.

Have you updated your E-Profile Number? Visit www.pssny.org to update your member profile today!

 

PSSNY Annual Midwinter Meeting

Continuing Education Schedule

Click here to view

 

 

 

Critical Background Information on AMMO for ALL Pharmacies:

 
Notes from meeting 10/31/2012 between PSSNY-NYCPS and NYS Department of Financial Services re implementation and enforcement of AMMO
 
The purpose of the meeting was to establish what new proactive steps, if any, the Department of Financial Services would take to implement and enforce the AMMO statute.
 
At the outset of the meeting it was made clear that neither Laura nor Geoffrey were in a position to bind the department to take any actions, but commitments were made to file a report with the agency director that would include:
 
  1. Recommend that the agency website to update consumer rights and protections to include a consumer’s right to access prescriptions from a local network pharmacy. 
  2. Look into the question of whether health plans are required to issue ‘riders’ that
announce the new ‘local option’ as required under the statute. Answer – Yes!
 
As a follow-up to the meeting, PSSNY agreed to provide examples of Gag Clauses in PBM contracts. (If you have examples, please send copy to PSSNY either via email: staff@pssny.org or fax (518) 464-0618. Real question whether these are legal and enforceable. Need examples for DFS to work from.
 
PSSNY learned the following:
 
1. Questions can be sent via e-mail to consumers@dfs.ny.gov
2. For a list of the major health plans in NY, go to www.dfs.ny.gov and look for "Consumer Guide to Health Insurance.”
3. It is not DFS policy to issue guidance documents that restate law. Insurers are expected to follow the law. "The law is the law.”
4. Enforcement of AMMO will occur through the investigation of complaints.
5. No requirement that health plans/PBM’s reach out to network pharmacies, but health plans are required to have a process in place to enroll pharmacies that contact them and ask for a copy of the "Mail Order Contract”DFS believes that under the statute the plan cannot deny this request. "They cannot say the network is full.”
6. AMMO applies to policies issued in NY by a company licensed in NY. Policies are reviewed by the department. DFS has no way of knowing when or if a policy that has been reviewed has been issued. Sign that NY DFS has reviewed the policy is a number that begins with NY somewhere on the card or policy.
7. Some insurance companies that are licensed in NY (i.e. CIGNA) have policies that are not reviewed by DFS, i.e. Medicare Advantage Plans. 
8. DFS has had complaints about violations of AMMO. DFS follows up with the health plan. If the initial response from the plan is not satisfactory, write back to DFS.
9. PSSNY can contact health plans on behalf of our members.
10.Individual pharmacists should contact health plans expressing willingness to participate in mandatory mail. AMMO does not apply to plans that do not have mandatory mail.
11. PBM’s are not regulated by DFS, but the health plans that hire them are responsible that state laws are followed.
12. Outreach area at DFS has limited resources. Focus is on areas in which consumers face potential harm, i.e. mortgage foreclosures, credit cards issued to students, etc.
13. Majority of policies renew on January 1. After January 11, 2013, AMMO statute will be in full force and effect.
14. This law will be enforced only through the complaint process. Pharmacists can complain on behalf of consumers or themselves.
 
Learned in informal conversation after the conference call ended: 
1)      AMMO clearly includes ‘specialty’ medications (Laura checked with counsel.)
2)      Laura is willing to follow up and investigate complaints from pharmacies that reimbursement to a network retail pharmacy is lower than mail order.
3)      Internally and informally, PBM’s are considered to be rogue. Defining PBM’s etc. is better under Public Health Law, not Insurance Law. 
4)      DFS is absolutely interested in stories from consumers about credit card abuses. Laura was told about the routine shipment of drugs (specialty included) that consumers no longer need, accompanied by credit card charges for the co-pay amounts that they cannot stop.
 

FOR A COPY OF THE *AMMO - Dear Patient Notice* PLEASE CLICK HERE

PSSNY, 210 Washington Avenue Extension, Albany, NY 12203 * 800-632-8822
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